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Initial Assessment Methods
(Adapted from AHCPR 1994)
X-Rays
Psychosocial Factors
Risk factors for chronicity
Management
Information to Patients
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Risk factors for chronicity
There are now a number of prospective cohort studies in primary
care which identify risk factors for chronicity.
Roland & Morris 1983 and Roland et al 1983
(same study), Troup et al 1981 and Lloyd & Troup 1983 (same
study), Biering-Sorensen 1984, Biering-Sorensen & Thomsen 1986,
Deyo & Diehl 1988, Burton & Tillotson 1991, Burton et al
1995, Klenerman et al 1995, Gatchel et al 1995.
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A number of clinical features
are risk factors for developing chronic pain and disability.
Roland et al 1983, Lloyd & Troup
1983, Biering-Sorensen 1984, Biering-Sorensen & Thomsen 1986, Burton
& Tillotson 1991.
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Psychosocial features are more
important risk factors for chronicity than biomedical symptoms and signs.
Deyo & Diehl 1988, Burton &
Tillotson 1991, Burton et al 1995, Klenerman et al 1995, Gatchel et al
1995.
(See also
Figure 2 - Biopsychosocial Assessment)
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Note: there are not
at present any RCTs that demonstrate whether psychosocial assessment
or interventions in acute low back pain affect clinical outcomes.
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